A new understanding of attention-deficit disorders--beyond the age-at-onset criterion of DSM-IV.

For decades, ADHD has been seen primarily as a behavior disorder affecting only young children, primarily boys, causing them to be inattentive and disruptive in school. Research has now established that ADHD affects females as well as males, and that impairing symptoms, for most, persist into adulthood. It has also been shown that this disorder impacts many aspects of life that extend well beyond problems in school. This disorder impairs not only one's ability to sit still and listen, but also the capacity to organize tasks and materials, to sustain effort on tasks, and to utilize short-term memory for daily activities. Studies of children, adolescents, and adults with ADHD indicate that many suffer from a variety of cognitive impairments that extend beyond symptoms listed in the DSM-IV diagnostic criteria for ADHD. These include chronic problems in regulating alertness, in reading comprehension, and in modulating emotions, that occur more frequently in persons with ADHD than in the general population. This article describes recent research findings demonstrating the wide range of cognitive impairments associated with ADHD, which are related to a new model of ADHD, such as developmental impairment of executive functions of the brain.